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Office of Health Affairs and HHS Release of Guidance for Patient Decontamination in a Mass Chemical Incident

-Acting Assistant Secretary for Health Affairs Dr. Kathryn Brinsfield

An important part of the Department of Homeland Security’s (DHS) mission is strengthening national preparedness and resilience, including against potential chemical incidents whether they are accidental or by malicious intent. The effects of chemical incidents, such as the explosion in West, Texas or the chemical spill in West Virginia can be devastating.

That is why the Department of Homeland Security (DHS) Office of Health Affairs (OHA) Chemical Defense Program, partnered with Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) and a working group comprised of various partners to research and write “Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities.” Compiled from evidence-based information, the document focuses on providing options for responses to events like chemical release and mass casualties.

This guidance is intended to support state and local civilian first responders and health care receivers, along with emergency managers, public health practitioners, law enforcement officials, and risk communications experts who are the nation’s first line of defense, and must be prepared to respond to potential chemical incidents.

Developed specifically for local communities, the document provides guidance as a tool to be added to the local planner’s toolkit. Providing evidence-based guidance and lessons learned before an incident occurs minimizes catastrophic effects and allows for information sharing between departments in order to enhance preparedness and improve response plans for these types of events.

During the development of this guidance, the Mass Human Chemical Decontamination Working Group (a federal interagency, working group of experts) identified three categories to address:

  1. risk assessment and decision making
  2. decontamination process and procedure                
  3. evaluation of results and patient follow-up

The working group developed this national planning guidance with the advice of a larger group of federal and non-federal subject matter experts in emergency response, emergency medicine, toxicology, risk communication, behavioral health and other relevant fields.

The working group was established at the request of the White House National Security Council and co-chaired by the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) and the Department of Homeland Security (DHS), Office of Health Affairs (OHA).

The approach in this guidance is flexible and scalable according to the resource and capability limitations of the community.  The recommendations should be adapted as each unique community sees fit according to their own hazard and risk assessment.  Examples of how this guidance might be used include:

  • Planners:  incorporate current evidence-based recommendations during development or revision of an organization’s response plans.
  • Community leaders, public health officials:  enhance system-wide coordination and develop plans for communicating with patients and the whole community.
  • Trainers:  develop, improve, or augment training of response personnel for patient decontamination operations, using current evidence-based recommendations.
  • Emergency managers:  generate policy and plans to address issues related to system-wide coordination, the whole community response, and crisis and risk communications, as well as other overarching issues.
  • Hospital emergency managers:  incorporate evidence-based recommendations into the hospital response plan and training program addressing the hospital’s unique challenges, and enhance coordination of the hospital response with those of the rest of the community through effective interagency planning and communication.
  • Researchers:  identify knowledge gaps and conduct research to investigate them.

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